A Comprehensive Review of Infectious Granulomatous Diseases of the Gastrointestinal Tract

Abstract

A granuloma is defined as a localized inflammatory reaction or a hypersensitive response to a nondegradable product leading to an organized collection of epithelioid histiocytes. Etiologies of granulomatous disorders can be divided into two broad categories: infectious and noninfectious (autoimmune conditions, toxins, etc.) causes. The endless list of causalities may prove challenging for gastroenterologists and pathologists to formulate a list of clearly defined differentials. This is true when distinguishing these etiologies based on various clinical presentations and endoscopic and histological findings. We aim to provide a comprehensive review of some of the frequent and rare infectious granulomatous diseases of the gastrointestinal tract documented in the literature to date. We provide an overview of each infectious pathology with an emphasis on epidemiology, clinical presentation, and endoscopic and histologic findings, in addition to treatment.

A Case Report of Tuberculosis in the Finger

“…This infection is also more prevalent in those with acquired immunodeficiency disease [2]. Extrapulmonary TB, in particular, is more common in females, HIV-positive patients, and in non-Hispanic blacks [3,4]. When a disease is this encompassing, it becomes critical for physicians to be familiar with even the least common manifestations of it.…”

Uncommon Types of Gastritis and Gastropathies Including Anti-parietal Cell, GVHD, Reactive and Granulomatous Gastritis

“…Infecting agents may be identifiable in many of the biopsy specimens; underlying aetiology is likely to vary according to geographical location of the patient and its ethnic origin. Majority of GG diagnosed in developed countries are noninfective type, whereas in developing countries it is likely to be infective aetiology [56,57]. The usual common infective conditions to be considered are tuberculosis, atypical mycobacterial infection, syphilis, Whipple's disease, actinomycosis, nocardia, a variety of fungal infections including cryptococcosis as well as anisakidosis, taeniasis and infestations with other parasitic worms and schistosomes [56,57].…”

“…Majority of GG diagnosed in developed countries are noninfective type, whereas in developing countries it is likely to be infective aetiology [56,57]. The usual common infective conditions to be considered are tuberculosis, atypical mycobacterial infection, syphilis, Whipple's disease, actinomycosis, nocardia, a variety of fungal infections including cryptococcosis as well as anisakidosis, taeniasis and infestations with other parasitic worms and schistosomes [56,57]. H. pylori has been associated with granulomatous gastritis and those patients responded to H. pylori eradication [58][59][60].…”